Breast Augmentation with Lift
Combination breast augmentation with lift options available at the Whole Beauty® Breast Center.
Why Dr. John Q. Cook Is the Right Breast Surgeon for You
Our patients benefit from Dr. Cook’s devotion to naturalism and extensive experience with breast surgery. He has performed thousands of operations with breast implants.
Dr. Cook is committed to an individualized analysis of each patient who comes to him for breast augmentation surgery. He considers your breast structure, your goals, and your activity pattern to find a solution that works for you.
We offer our patients a detailed analysis, which includes anatomical breast sizers and simulation software to help you visualize your potential results. We also have an extensive database of before and after photos that our patients have allowed us to share during the consultation process.
Dr. Cook’s experience with complex breast reconstruction surgery provides him with a wide range of technical refinements that he can use to optimize results for his breast augmentation patients.
Education and Credentials
Awards and Recognition
REAL PATIENT RESULTS
See the difference experience makes. View the full before & after photo gallery of Dr. Cook and his team.
Breast Augmentation with Lift
Address Sagging and Enhance Volume at the Same Time in Chicago and Winnetka
Many women come to Dr. John Q. Cook for restoration of a more youthful breast structure and form. Pregnancy, weight fluctuation, or simply the aging process can produce a situation where the breasts have settled to a low position on the body and have lost volume. Often, the solution to this situation is a combined operation that involves implants and a lift. Dr. Cook offers his patients an extensive portfolio of options for this combined operation, which is sometimes referred to as an augmentation mastopexy. The specific choice is based upon each woman’s goals, lifestyle, and physical structure.
There are some patients who require a restoration of breast volume and just need a minor lift. In this case, implants alone can be helpful. If the patient has a reasonable amount of natural breast structure in the upper part of the breast, implants can be placed under the breast and above the pectoral muscle. By filling out the breast, implants will produce a minor degree of lifting. If a patient has relatively little upper breast structure, Dr. Cook can place the implants behind the pectoral muscle, which gives a natural slope to the upper part of the breast. He will also reposition the lower portion of the pec muscle, so that the implant fills and rounds out the lower portion of the breast.
Who Should Consider Breast Augmentation with Lift?
The first question you should ask is, “Am I happy with my breasts when they are supported in a bra, or do I desire more volume as well?”
If you are happy with your breasts when they are supported by a well-structured, non-padded bra, it is possible that a breast lift without implants will satisfy your needs. There are a number of possibilities that are discussed thoroughly in the lift section of this website. The structural breast lift, a technique that Dr. Cook has developed, is often a good solution, in that it allows for a redistribution of breast volume to the upper portion of the breast.
On the other hand, if you feel that your breasts look under-filled or deflated, even when supported with a bra, the combination of a lift with implants will probably be best suited to your needs.
Except for women with very small breasts, almost every woman will eventually experience a loss of breast tone and structure, so that a portion of the breast will overhang the natural fold under the breast. Plastic surgeons refer to this settling or drooping of the breast structure as “ptosis.”
Here is a simple test you can perform on yourself to see if you need a lift as well as a breast implant. Place a pencil so that it sits up against the fold under the breast and look at your breast in the mirror.
If your nipple sits below the level of the pencil, you should combine a breast augmentation with lift. If the degree of overhang is milder, you may still need a lift if you want a relatively “perky” breast structure. If there is just a little bit of overhang—for example less than one inch in a larger breast—implants alone may produce enough of a lift to achieve a nice breast shape.
Please bear in mind that these are general guidelines. They will vary with your personal circumstances, but they will hopefully point you in the right direction. In any case, it is important to seek the opinion of a highly experienced plastic surgeon who performs a significant number of advanced breast surgeries.
Breast Augmentation with Lift Techniques
There is no “one-size-fits all” operation for every patient who wants to lift her breasts and restore volume. Dr. John Q. Cook and the Whole Beauty® Institute team combine a careful consideration of your goals with a detailed analysis of your individual breast structure in order to develop a surgical strategy that suits your needs.
Options include augmentation combined with periareolar mastopexy to correct a pointed breast shape or asymmetry of the nipples, areola, or breasts; structural mastopexy with implants; vertical mastopexy with implants; and a classic (anchor) lift combined with augmentation.
Augmentation Combined with Periareolar Mastopexy
If your breasts have settled beyond where they can be “lifted” with implants, but not to the extent that the nipples lie below the level of the fold under the breast, a combined periareolar lift with breast implants may work well for you.
A periareolar lift combined with silicone gel implants worked nicely for this patient. She did not require an aggressive lift, and the breasts have achieved a nice, natural shape. Click the image to see it in the photo gallery.
Dr. Cook often uses this breast augmentation with lift combination for patients who have lost tone and volume in their breasts after pregnancy and breastfeeding, and sometimes for patients who have lost significant weight but who haven’t experienced severe breast settling.
The basic concept of this breast augmentation with lift surgery is simple. Dr. Cook makes a circular incision around the border of the areola or within the areola if it has been stretched out by pregnancy. Another oval-shaped incision is made farther out in the skin of the breast, and the skin between the circle and the oval is removed. As the outer oval is brought to the inner circle with stitches, the breast is tightened and lifted. There are a number of technical embellishments to this technique, but this describes the basic concept of the breast augmentation with lift surgery.
The periareolar lift was developed several decades ago, but it never caught on for one simple reason: The tension that resulted from bringing the outer oval to the inner circle often caused the resulting scar to spread. Dr. Louis Benelli, a French surgeon, made a significant contribution when he developed the “blocking suture” technique. Also called a “purse string” suture, the blocking suture is placed under the skin at the edge of the outer oval so that it runs around the entire margin. When the surgeon tightens this suture and secures it with a knot, this reduces the oval to the size of the inner circle and removes the tension that would otherwise cause the scar to spread. Dr. Cook learned this technique from Dr. Benelli in one of his courses and has found it to be helpful and effective in the right breast augmentation with lift patients.
Periareolar Mastopexy with Augmentation to Correct a Pointed Breast Shape
Many of the patients who see Dr. Cook in consultation for breast augmentation have significant concerns regarding breast shape as well as breast size. One common issue is the pointed breast, which tends to over-project in the area beneath the areola. Some patients are very self-conscious about this particular breast shape.
The periareolar mastopexy can be a great friend to patients with pointed breasts, since it de-projects the pointed area of the breast right in the area where this is needed. Dr. Cook often combines other advanced breast surgery techniques under these circumstances to help my patients achieve the shape that they desire.
The combination of the periareolar lift with silicone gel implants helped this patient obtain a pleasing breast shape. Click the image to view in photo gallery.
Periareolar Lift Combined with Implants to Correct Nipple and Areolar Asymmetry as well as Breast Asymmetry
Many patients have breasts that are two different sizes. Dr. Cook can help these patients by placing a larger implant behind the smaller breast and a slightly smaller implant behind the larger breast.
Sometimes the asymmetry of the breasts is accompanied by asymmetry of the areolae, either in position or size. To a degree, it is possible to shift the axis of the breast so that an areola that is pointing too far inward or outward can be oriented in a better direction. Dr. Cook has also used the periareolar lift technique to help patients who have one areola of a larger diameter than the other.
Structural Mastopexy with Implants
The development and refinement of the structural lift and other forms of structural breast surgery have been a major focus of Dr. Cook’s creative work in the field over the last seven years. In his opinion, the structural lift has significant advantages over many other breast lifting techniques. These advantages include a restructuring of the breast tissue to replenish missing volume in the upper part of the breast, deep multi-level anchoring of the breast to help maintain the lift, and more limited scars than a traditional lift.
The structural breast lift combined with implants is his preferred technique for patients who need a greater amount of lifting than can be accomplished with a periareolar lift and who also need additional breast volume.
Vertical Mastopexy with Implants in the Context of Structural Lifting
There was a time when Dr. Cook did quite a few vertical lifts. This procedure was significantly refined by surgeons in France and Brazil, such as Dr. Lasus and Dr. Pitanguy. It took the better part of two decades, however, for this operation to be widely adapted in the United States.
The main appeal of this procedure was avoiding creation of a scar that runs along the fold under the breast as happens with the classic breast lift technique— sometimes referred to as an “anchor” lift because of the location of the scars. There are different variations of this surgery, some of which just rely on the skin to lift the breast, while others tighten the deeper breast structure. The vertical lift technique can be combined with augmentation.
With the structural lift technique, Dr. Cook believes that he can control more aspects of the breast form than he could accomplish with vertical lifts, so he currently perform the latter much less frequently.
Classic (Anchor) Lift Combined with Augmentation
Many surgeons in the United States still use this as their main technique for a lift combined with implants. Those who criticize this operation do so on the basis of the extent of the scars, which run around the areola, straight down from the areola to the fold under the breast, and along much of the fold, both in the inner and outer parts of the breast.
Although scars are important, a more significant disadvantage of the classic lift is that it relies on the skin to do the lifting. For many people, skin lifts don’t last very long, and the lower portions of the breast stretch out.
There is a group of patients for whom Dr. Cook still uses the classic lift combined with implants. These are patients in whom the main stretching out of the breast is along horizontal rather than vertical lines. This is sometimes seen in patients who have lost a very significant amount of weight. Even in these patients, Dr. Cook will often incorporate elements of the structural technique for the deeper parts of the breast, although the pattern of the external scars does not reveal this.
Why Should You Not Rely on Implants Alone to Provide a Significant Lift?
Although implants can provide a mild breast lift, using the devices alone is a very bad strategy for a surgeon looking to push this simple idea to extremes. Unfortunately, we still see too many patients whose former surgeons placed very large implants immediately under the breast in an attempt to avoid a lift. The result can look forced and unnatural just after surgery, and several more undesirable things may happen over time: The natural tissue of the breast can thin and reveal irregularities in the implant, including rippling; large implants can pull down already sagging breasts to make their droopier; and a “double contour” can form, especially in women with narrow, droopy breasts.
There is an exception: Note that for some breasts, a mild lifting effect can be obtained with implants alone. There are some breasts that droop mainly due to a loss of volume. These breasts have a relatively small amount of overhang. For many years, Dr. Cook has used a technique that he calls pectoral repositioning to allow an implant to properly fill out the lower portion of the breast while providing proper coverage of the implant in the upper portions of the breast. This technique is also referred to by some surgeons as bi-planar augmentation. If you have breasts that have lost volume and are mildly settled, this may be a good choice for you. The breasts will still have a somewhat “mature” look, which is preferable to many patients. If there is still enough structure in the upper portion of the breast to camouflage an implant, another option is for Dr. Cook to place the implant underneath the breast, but above the pectoral muscle. During the consultation, Dr. Cook will let the patient know if these options would make sense.
What Role Do Implants Play in Restoring Volume to the Upper Portion of the Breasts?
There are surgeons who routinely use implants with virtually all of their mastopexies—even for patients who do not desire more breast volume. This is particularly true for surgeons who use techniques that rely on the skin to lift the breast. This strategy makes a certain amount of sense, since with skin-level breast lifts, there will be a significant stretching out of the lower portion of the breast with the passage of time. As this happens, the upper part of the breast will empty out and appear hollow. If an implant is placed, the volume of the device will help to maintain fullness in the upper part of the breast.
Since most of the lifts that Dr. Cook performs make use of the structural technique, he finds that he has less need to use implants for the sole purpose of providing upper pole volume than he did in the past. Dr. Cook occasionally sees patients whose breast structure makes this strategy a logical choice, even when combined with a structural lift. For some patients, it is possible to use the fat transfer process to restore breast volume, which does away with the need for implants.
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